Michael A Granieri1, George D Webster2, Andrew C Peterson2. 1. Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC. Electronic address: Michael.Granieri@duke.edu. 2. Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Abstract
OBJECTIVE: To examine the timing, incidence, and resolution of scrotal and perineal sensory neuropathy after urethroplasty for bulbar urethral stricture disease. MATERIALS AND METHODS: We performed an institutional review board--approved retrospective review of our urethroplasty database with specific attention paid to patient demographics, stricture location, repair type, and postoperative sensory neuropathy defined as the complaint of hypesthesia, anesthesia, paresthesia, hyperesthesia, and pain in the scrotal and perineal region after surgery. Incidence and reported times to onset and resolution of sensory neuropathy were compared among our cohort. RESULTS: A total of 155 men underwent urethroplasty for bulbar urethral stricture disease from January 2007 to December 2012. One hundred forty-three of 155 men (92%) had postoperative data available for analysis. The average age at surgery was 47 ± 15 years and average stricture length was 2.1 ± 1.4 cm. Repair types were excision and primary anastomosis (101 of 143; 71%), augmented anastomotic repair (31 of 143; 22%), onlay repair (4 of 143; 3%), and perineal urethrostomy (7/143, 5%). Twenty of 143 men (14%) experienced postoperative scrotal and perineal neuralgia at a median time of 108 days (range, 18-160 days) from surgery. Fourteen of 20 men (70%) had subsequent follow-up visits, and all of these men had resolution of the pain, without treatment, at a median reported time of 271 days from surgery. There were no significant differences in incidence, resolution, or timing of sensory neuropathy among repair types. CONCLUSION: Our findings indicate that approximately 14% of men who undergo urethroplasty for bulbar urethral stricture disease experience postoperative scrotal and perineal sensory neuropathy. This appears to be transient with 100% resolution in our patients with available follow-up.
OBJECTIVE: To examine the timing, incidence, and resolution of scrotal and perineal sensory neuropathy after urethroplasty for bulbar urethral stricture disease. MATERIALS AND METHODS: We performed an institutional review board--approved retrospective review of our urethroplasty database with specific attention paid to patient demographics, stricture location, repair type, and postoperative sensory neuropathy defined as the complaint of hypesthesia, anesthesia, paresthesia, hyperesthesia, and pain in the scrotal and perineal region after surgery. Incidence and reported times to onset and resolution of sensory neuropathy were compared among our cohort. RESULTS: A total of 155 men underwent urethroplasty for bulbar urethral stricture disease from January 2007 to December 2012. One hundred forty-three of 155 men (92%) had postoperative data available for analysis. The average age at surgery was 47 ± 15 years and average stricture length was 2.1 ± 1.4 cm. Repair types were excision and primary anastomosis (101 of 143; 71%), augmented anastomotic repair (31 of 143; 22%), onlay repair (4 of 143; 3%), and perineal urethrostomy (7/143, 5%). Twenty of 143 men (14%) experienced postoperative scrotal and perineal neuralgia at a median time of 108 days (range, 18-160 days) from surgery. Fourteen of 20 men (70%) had subsequent follow-up visits, and all of these men had resolution of the pain, without treatment, at a median reported time of 271 days from surgery. There were no significant differences in incidence, resolution, or timing of sensory neuropathy among repair types. CONCLUSION: Our findings indicate that approximately 14% of men who undergo urethroplasty for bulbar urethral stricture disease experience postoperative scrotal and perineal sensory neuropathy. This appears to be transient with 100% resolution in our patients with available follow-up.
Authors: Malte W Vetterlein; Almut Gödde; Luis A Kluth; Valentin Zumstein; Philipp Gild; Phillip Marks; Armin Soave; Christian P Meyer; Silke Riechardt; Roland Dahlem; Margit Fisch Journal: World J Urol Date: 2021-03-11 Impact factor: 4.226